Helping a man at risk of suicide

It is distressing to realise that someone close to you may be considering suicide. The below information will help you in helping someone with suicidal thoughts; to identify signs to look for, decide what to do and learn what help is available.

Most people who consider suicide do get through the crisis. Family, friends and professionals can make a big difference in helping people stay safe and re-establish reasons for living.

Men who have experienced child sexual abuse and suicidal thoughts

Suicidal thoughts can be a recurring theme for some men who have experienced child sexual abuse or sexual assault. Talk of suicide should always be taken seriously, particularly as research suggests that men who were sexually abused are up to 10 times more likely to experience suicidal thoughts. In one study, 46% of men with a history of childhood sexual abuse indicated that they had attempted suicide. Add to this the fact that males are almost 4 times more likely than females to die by suicide (with men in age 30-44 years the most at risk) then it becomes important to be prepared to ask about and deal with suicidal thoughts.[1]

Behaviours to look out for – what is he doing?

People at risk of suicide usually give clues by their behaviour. These may include:

Previous suicide attempts

Being moody, sad and withdrawn

Talking of feeling hopeless, helpless or worthless

Taking less care of himself and his appearance

Losing interest in things he previously enjoyed

Finding it hard to concentrate

Being more irritable or agitated

Talking or joking about suicide

Expressing thoughts about death through drawings, stories, songs etc

Saying goodbye to others and/or giving away his possessions

Engaging in risky or self-destructive behaviour

Increasing alcohol/drug use

Mental Health

Mental health problems can increase the risk of suicide. We may not know a person’s mental health history, however we may notice that a person seems depressed or anxious, and/or is misusing alcohol or other drugs. They may have told us that they are receiving treatment for a mental health problem.

Having a mental health problem does not mean a person will have thoughts of suicide – many don’t. However, mental health problems can affect the way people view problems. They affect motivation and openness to seek help, therefore we need to be particularly aware of the possible risk of suicide.

People who have recently been discharged from hospital for treatment of mental health problems may also be at higher risk of suicide. It is important that they receive ongoing support in the community. You may be able to help by supporting them to attend any follow-up visits with their GP or mental health specialists.

What do I do now?

People considering suicide often feel very isolated and alone. They may feel that nobody can help them or understand their psychological pain. When unable to see any other way of dealing with pain, suicide may seem to be a way out. Sometimes people who have been distressed and openly suicidal become outwardly calm. Be aware that this may mean many things, including their quiet resolution to complete their suicide plan.

The important thing to remember is that if someone is not their usual self or if they are showing signs that arouse your concern you need to check it out. This tool kit will help you to talk to someone about suicide and then decide what steps to take.

Most people who consider suicide get through the crisis. The help and support of family, friends and professionals can make a big difference. The following tips will help you know what to do.

Practical steps you can take

1) Do something now

If you are concerned that someone you know is considering suicide, act promptly. Don’t assume that they will get better without help or that they will seek help on their own. It’s easy to avoid being part of that help, or to hope that someone else will step in. Reaching out now could save a life.

2) Acknowledge your reaction

When you realise that you need to take action to help someone who is considering suicide, your natural reaction may be to:

Panic

Ignore the situation and hope it will go away

Look for quick-fix solutions to make the person feel better

Criticise or blame the person for their feelings

These reactions are common but not helpful. It’s natural to feel panic and shock but take time to listen and think before you act. Following the tips below will help you get through. If you find you’re really struggling, enlist the help of a trusted friend.

3) Be there for him

Spend time with the person and express your care and concern. Ask them how they are feeling, hear their pain and listen to what’s on their mind. Let them do most of the talking. Problems can seem more manageable after speaking about them.

4) Ask him if he is thinking of suicide

Unless someone tells you, the only way to know if a person is thinking of suicide is to ask. Asking can sometimes be very hard but it shows that you have noticed things, been listening, that you care and that they are not on their own. Talking about suicide will not put the idea into their head but will encourage them to talk about their feelings. It opens up options for checking out risk, attending to safety and getting further help.

5) Check out his safety

If a person is considering suicide it is important to know how much thought they have put into it. Ask about the following:

Have they thought about how and when they plan to kill themselves?

Do they have the means to carry out their plan?

Have they ever deliberately harmed themselves?

What support can they access to stay safe and get help?

How can you help them draw on links to family, friends, pets, religious convictions, personal coping strengths?

Use this information to decide what to do. If you are really worried, don’t leave the person alone. Seek immediate help – see contact numbers below or phone Lifeline on 13 11 14. Remove any means of suicide available, including weapons, medications, alcohol and other drugs, even access to a car.

6) Decide what to do

Now that you have this information you need to discuss together what steps you are going to take. What you decide to do needs to take into account the safety concerns that you have. Do not agree to keep it a secret. You may need to enlist the help of others to persuade the person to get professional help – or at least take the first steps to stay safe. These may include their partners, parents, or close friends. Only by sharing this information can you make sure that the person gets the help and support they need. Sometimes the person at risk says they do not want help. Yet we know most people are in two minds about suicide. Make keeping them safe your first priority. Consider the long-term benefits of getting help for the person. It may mean risking the relationship but you could be saving a life.

7) Take action

A man can get help from a range of professional and supportive people:

Counsellor, psychologist, social worker

School counsellor, youth group leader, sports coach

Emergency services – police and ambulance

Mental health services

Community health centres

Priest, minister, religious leader

Telephone counselling services such as Lifeline and Kids Help Line

When the person has decided who they are most willing to tell, help them prepare what they will say. Many people find it difficult to express their suicidal thoughts. Offer to accompany the person to the appointment. After the appointment, check that they raised the issue of suicide and ask what help they were offered. Help them follow through with the recommendations. In some situations the person may refuse to get help. While it’s important that you find them the help they need, you can’t force them to accept it. You need to ensure that the appropriate people are aware of the situation. Do not shoulder this responsibility alone.

8) Ask for a promise

Thoughts of suicide often return and when they do it is important for the person to again reach out and tell someone. Asking them to promise to do this makes it more likely that it will happen. Encourage the person to promise to call you or Lifeline 13 11 14 if the suicidal thoughts return, and to do this before they harm themselves.

9) Look after yourself

If you’re helping someone who is considering suicide, make sure you also take care of yourself. It is difficult and emotionally draining to support someone who is suicidal, especially over an extended period.

Don’t do it on your own. Find someone to talk to, maybe friends, family or a professional.

Recruit other people to help support the person you are worried about.

Get in touch with carer organisations or support groups. Contact Lifeline’s Just ask 1300 13 11 14 to find what’s available in your area.

Try not to let your concerns about the other person dominate your life. Make sure you continue to enjoy your usual activities, take time out to have fun and keep a sense of perspective.

10) Stay involved

Thoughts of suicide do not easily disappear without the person at risk experiencing some change. Their situation, or their feelings about it, may change, or they may feel more supported and able to deal with it. In either situation, the continuing involvement of family and friends is very important. Below are some tips to ensure the person at risk continues to get the best help possible:

Ensure the person has 24-hour access to some form of support. This may be you, other family members and friends, or Lifeline 13 11 14.

Accompany the person to appointments if possible. Your support can be a great encouragement.

If you are the primary carer, try to establish a good relationship with the health professionals responsible for the person’s treatment. Your opinion and input is valid and may be very valuable.

Advocate for the person. Sometimes a service or health professional may not be capable of meeting all the person’s needs. You can advocate for appropriate services.

Discuss with the person what issues or situations might trigger further suicidal thoughts. Plan how to reduce this stress and what coping strategies can be used.

Continue to be supportive but not overprotective.

Where to get help

For immediate crisis intervention when life may be in danger ring the police on 000 or go to your local hospital emergency department.

Resources

Beyond Suicide Attempts booklet – information for parents, foster parents and guardians following the suicide attempt of a young person. Available from Lifeline’s Just ask Training: ASIST – many Lifeline Centres throughout Australia provide Applied Suicide Intervention Skills Training (ASIST) if people are looking for further training in this area. Contact LivingWorks to find an ASIST training near you, 03 9894 1833 or [email protected]

Acknowledgements

The Australian Government Department of Health and Ageing under the National Mental Health Strategy.

The Illawarra Institute for Mental Health.

Lifeline’s Just Ask.

[1] P.J. O’leary, Doctoral Thesis Flinders University 2003; Life is for everyone. Promoting good practice in suicide prevention: Activities targeting men. Australian Government Department of Health and Ageing: 2008.

1 comment

Comment by Katie

Help. I have a friend who lives in another country who is suicidal. He has repeatedly stated “I do not like talking about my problems. I have many problems here.” He is depressed bc of no work, money, girlfriend broke up with him months ago. Over time he has opened up a little to me and shared some of his problems. I do not give advice nor do I act as his therapist. I listen and support him. I remind him that his circumstances to not define who he is and that I do know what hopelessness and suicidal ideation feels like as I have been there myself. I’m trying to create a “safe place” for him to go to bc he won’t talk to anyone but me.
when he is suicidal he has anger outbursts saying “I hate life. I can’t be who I want to be. Why can’t I just be happy like everyone else?!”

I have absolutely no idea what to say. I tell him I’m listening. Last night I tried to identify with him in hopes that he would continue talking. I said “do you feel like there is no solution?” “Do you feel trapped?”

He cut me off and said “goodnight” He told me one time that he does this when he is extremely sad. However, this leaves me in a state of worry and anxiety bc I can’t get to him physically and I know if i contact any of his friends it would make him more angry.

It like he reaches out to me by telling me he wants to kill himself but everything I say or don’t say causes him to shut down. So I finally said “please talk to someone. It does not have to be me. I love you and I know you don’t like talking about your problems but you might be surprised at how much it helps.”
Please text me in the morning to let me know you are ok. ”

He did by saying “good morning” like nothing had happened. I replied “thank you for letting me know and I hope today is better”

Bottom line: what do I do? Clearly he has feelings of hopelessness that his future will never change, emotionally unavailable, hates himself, feels like he’s not good enough and has said he thinks something is wrong with him bc he compares himself to his friends.

I told him he needs to talk to someone and it doesn’t have to be me bc I feel like I say all the wrong things. He didn’t respond. So sometimes i feel like a doormat, but I try to not take it personally. I’m pretty good at this , but as the episodes are more frequent I’m becoming frustrated and feel hurt. Do I say something about this? When these episodes happen again what do I say?

We welcome donations and opportunities to work in partnership with individuals and organisations. Living Well is an initiative of Anglicare Southern Queensland. Supported by the Queensland Department of Justice and Attorney General and private donations.